708 ACTIVE IMMUNIZATION 



Vulvovaginitis of Children. Stock gonococcal vaccines have been 

 used quite extensively in the treatment of this troublesome infection. 

 On the whole, good results have been reported, although in any case 

 final judgment must be reserved until thorough bacteriologic examina- 

 tion shows whether the tissues are really free from infection or whether 

 the infection has subsided and become chronic. Smears of the secretions 

 alone are insufficient to determine whether a cure has been effected. 

 Injecting a solution of 1 : 2000 bichlorid of mercury in normal saline 

 solution into the vagina, followed by immediate centrif ugalization of the 

 washings and smears of the sediment, will frequently demonstrate the 

 presence of gonococci that will not otherwise be found. If vaccines are 

 used, a dose of from 5,000,000 to 10,000,000 every five to seven days 

 may be employed. 



RESPIRATORY DISEASES 



Rhinitis. The use of mixed stock vaccines is being advocated for 

 prophylactic immunization against recurrent attacks of acute rhinitis. 

 Numerous reports by Coates, Fisher, and others have emphasized the 

 value of this prophylactic immunization. With Weston, I have found 

 autogenous vaccines of some value in lessening the severity and hasten- 

 ing the recovery from the acute rhinitis of scarlet fever, so potent a 

 factor in the dissemination of that disease. In chronic rhinitis an au- 

 togenous vaccine, prepared by growing cultures with the care previously 

 described, may be of distinct value, but only when an underlying factor, 

 such as a malformation or adenoids, has been removed, and only when 

 used in conjunction with efficient local treatment. In atrophic rhinitis 

 good results have been reported by various observers with a vaccine of 

 Bacillus ozena (Perez) ; in the experience of Ersner, working in my labor- 

 atory, the results have been usually disappointing. In view of the diffi- 

 culty in curing this disease, a vaccine may be tried as an adjuvant to 

 other measures. 



Hay-fever. Hay-fever is now regarded as due to a state ol anaphy- 

 laxis or hypersensitiveness to the pollen of certain plants and grasses. 

 Spring fever or "rose cold" may be due to the pollens of a wide variety 

 of grasses and plants (red top timothy, rye, and orchard grass), while 

 autumnal hay-fever is most frequently due to the pollens of rag-weed 

 and golden-rod. Since the brilliant researches of Blackley, 1 a large num- 

 br of investigations have served to establish the nature of this trouble- 

 some disease on the basis of idiosyncrasy or local hypersensitiveness 

 to the protein of one or more plants. According to Cooke and Vander 

 1 Virchow's Archives, 1877, Ixx, 429; Med. Times and Gaz., 1877, 2, 243. 



